Technical consultation on Implementation
of the Global Strategy for Infant and Young Child Feeding

Introduction

The Global
Strategy for Infant and Young Child Feeding (IYCF) was developed jointly
by UNICEF and WHO after a two year participatory process involving
the governments of all WHO member states, international and intergovernmental
agencies, health professionals and nongovernmental organizations.
In May 2002, the World Health Assembly (WHA) adopted the Global Strategy
as Resolution WHA55.25.

As a nongovernmental
organization in official relations with WHO, La Leche League International
(LLLI) was invited to send a representative to a technical consultation
on the Global Strategy for IYCF, to take place February 10-12, 2003
in Geneva, Switzerland. Due to the current financial situation and
as one of two LLLI representatives to WHO and UNICEF in Geneva, I
agreed to represent LLLI at this meeting. Lynne Coates (Acting Executive
Director and Chairman of the LLLI Board), Rebecca Magalhães
(Director, External Relations & Advocacy), Natalia Smith (Special
Projects Assistant) and I worked together to prepare for LLLI representation.
A number of LLLI materials and documents were sent to Geneva for distribution
to the participants, and a summary of LLLI's
contributions (in rich text format, viewable by most word processors)
to the aims of the Global Strategy was prepared, noting past, present
and hopefully future activities.

Technical
Consultation - Meeting Process

The meeting
objectives were:

to discuss
the best ways for achieving progress in the operation areas defined
in the Global Strategy

to reach
a common understanding on a generic planning framework to facilitate
the implementation of the GSIYF in countries

to identify
tools available to support implementation as well as those that
need to be developed

to agree
upon priority developmental and research needs and mechanisms to
coordinate future work

Fifty-one
(51) persons attended the meeting, with representation from WHO headquarters
and regional offices, UNICEF, governments, the World Bank, International
Labour Organization and two universities. Other agencies and nongovernmental
organizations joined LLLI, with persons attending from BASICS, CARE,
CEPREN, IBFAN, IFPRI, ILCA, LINKAGES, Manoff group, and CORE. Outside
of the on-site WHO/Geneva personnel, there were 9 persons from Africa,
5 from Asia, 7 from Europe and 13 from the Americas.

Each day there
was a succession of 15 minute presentations about the different aspects
of the Strategy, its implementation and implications. Following
the presentations, participants worked in four different groups. The
results of the work groups were presented the next morning or immediately
afterward on the last day.

During the
afternoon of the last day, time was set aside for each agency or NGO
present to talk about what they did and what could be their contribution
for the implementation of the Strategy.

Technical Consultation - Discussions

The Global
Strategy builds on past and continuing achievements, such as the Baby
Friendly Hospital Initiative, the International Code of Marketing
of Breastmilk Substitutes, and the Innocenti Declaration. Other texts
and actions that are also relevant are the World Declaration and Plan
of Action for Nutrition and the ILO Convention.

The Strategy
addresses the promotion of appropriate feeding for infants and young
children, particularly exclusive breastfeeding for six months and sustained
breastfeeding with appropriate complementary food for two years and
beyond. Special circumstances and feeding children in exceptionally
difficult circumstances (low birth weight babies, emergencies, HIV infected
women, women in prison) are also taken into account in the Strategy
and were discussed during the meeting.

Complementary
feeding is currently a very important topic, as the transition from
exclusive breastfeeding to sustained breastfeeding with adequate complementary
food is very poorly practised in many parts of the world. Randa Saadeh,
Department of Nutrition for Health and Development, WHO, is finalizing
a WHO Complementary Feeding Counselling course.

Technical
Consultation - Personal Points

There were
many very interesting PowerPoint presentations and it is difficult
to give too many details in a short report. However, there will be
a general report of the consultation produced later. If anyone needs
details from one of the presentations, please email me LAVIOLLE.Gisele@wanadoo.fr
and I will provide you with what I can.

Being at the
meeting provided an opportunity to network with many people who are
actively involved in breastfeeding promotion, protection and support.
It was also very interesting to talk to people during breaks and lunch.

Another representative
from an NGO and I commented together how big agencies and NGOs appear
to have funding to carry on their actions and are able to acquire
human resources with expertise. They are also able to implement studies
and pilot projects and carry out evaluations. NGOs such as LLLI and
others can feel inadequate in comparison. On the other hand, these
agencies often target a country, carry on a big project and then leave,
whereas small grass-root organizations have a lasting and permanent
effect on the ground.

There were
three LLL Leaders/retired Leaders at the meeting - Margaret Kyenkya, Elizabeth
Hormann and myself. It was nice to speak with them about our work
and possibilities in LLL.

During the
last break, a question was posed to me by a WHO person: is LLL going
to get busy in complementary feeding? This happened just before I
was going to give the LLL presentation. After discussing this with
several people, I realized that the participants needed more from
LLL than just the things we had prepared. I made photocopies of the
leaflet Becoming a La Leche League Leader and distributed this along
with the prepared paper. Thus the participants had the ten concepts of LLL
to look at and I was able to show them that complementary feeding
has indeed been part of LLL work for a long time. I also spoke of
the importance of the LLL Leader who has expertise and experience
in helping a mother, and of our members who are passionate about breastfeeding.
As I was speaking, I saw a woman raise her hand showing that she had
been helped by LLL, and when I had finished, one of the participants
mentioned to me that she was an LLL member. In the time allocated,
I also went through the different points covered in the paper.

Concluding
Thoughts and Recommendations

Overall, the
meeting was very interesting and it was valuable for LLLI to be represented
at this meeting. Although the time was too short to cover all the
meeting objectives, the work on the Global Strategy will continue.
The different work groups made suggestions and recommendations that
will be included in the final report.

I recommend
that LLLI stay in close touch with WHO and UNICEF in order to assist
with the implementation of the Strategy in the areas that LLLI knows
best. It would also be important for LLLI to create an internal workgroup
to study the Strategy in depth, define which tools we can propose
that we have already and see if it is possible for us to propose other
tools. I also recommend that LLLI be more proactive in relation to
the other agencies, as LLLI has the hands-on expertise.